“Making Healthcare Right. Together.” is the cornerstone of all we do. Our vision is through powerful relationships with Care Partners, we help all people live healthy and brighter lives. To successfully achieve our mission and vision as we operate in a dynamic health care environment, we expect Bright employees to embody and uphold our core values in work and interactions, both internal and external: be brave, be brilliant, be accountable, be inclusive, and be collaborative.

The Director, Actuarial Services – Medicare Advantage (MA) will have the lead role in MA Line of Business pricing, risk management, strategy decisions and block management.

ROLE RESPONSIBILITIES

• Support the Government Programs Actuarial Models team’s development of actuarial models to be used for medical expense and trend analysis and forecasting, pricing, and bid (BPT) development
• Lead an inclusive (to be developed) quarterly (3x per year) medical expense analysis and forecasting process in coordination with various MA LOB SMEs and LOB leadership
• Lead responsibility for pricing work, bid (BPT) submissions and approvals, including desk review and bid audit responses
• Manage and mentor Consulting Actuaries and Analysts to achieve work deliverables and ensure their development relative to team growth goals
• Lead development of pricing assumptions to inform pricing decisions and plan benefit development and provide guidance to the LOB team
• Support product and line of business strategy working with MA LOB leadership

SUPERVISORY RESPONSIBILITIES

• This position will have supervisory responsibilities including Consulting Actuaries and Analysts

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE

• A Bachelor’s degree in Math, Statistics, Economics, Actuarial Science, or a related field is required
• Ten (10) or more years of experience working as a health care actuary, with a minimum of 5 years with Medicare Advantage products is required
• Associate or Fellow of the Society of Actuaries
• Meets or exceeds continuing educations requirements for SOA and the American Academy of Actuaries
• Understanding of healthcare claims data

PROFESSIONAL COMPETENCIES

• Proficient in Microsoft Excel and other Office products
• Experience with forecasting, modeling, and SQL or SAS
• Expert level knowledge of healthcare pricing and bid development for Medicare Advantage products
• Understanding of company practices related to management of member populations for purposes of estimating risk
• Produce, understand, and interpret internal and external analyses and reports; provide effective technical and non-technical support to internal and external stakeholders
• Strong communication and collaboration skills
• Strong management and leadership skills
• Ability to clearly and concisely present complex technical analyses and recommendations to C-Level leadership

LICENSURES AND CERTIFICATIONS

• Associate or Fellow of the Society of Actuaries 

ABOUT US

At Bright Health, we brought together the brightest minds from the health care industry and consumer technology, and together we created Bright Health: a new, brighter approach to healthcare, built for individuals. Our plans are easy to manage, personalized, and more affordable, giving people the quality care they deserve. Through our exclusive care partnerships with leading health systems in local communities, we are reshaping how people and physicians achieve better health together.

We’re Making Healthcare Right. Together. 

We've won some fun awards like Modern Healthcare and Forbes, etc. But more than anything, we're a group of people who are really dedicated to our mission in healthcare. Come join our team!

As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of Bright Health, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

BRIGHT ON!